Two-month stop in mammographic screening significantly impacts on breast cancer stage at diagnosis and upfront treatment in the COVID era.
Two-month stop in mammographic screening significantly impacts on breast cancer stage at diagnosis and upfront treatment in the COVID era.
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DOI：
10.1016/j.esmoop.2021.100055
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发表时间：
2021-04
期刊：
影响因子：
7.3
通讯作者：
Tazzioli G
中科院分区：
文献类型：
--
作者：
Toss A;Isca C;Venturelli M;Nasso C;Ficarra G;Bellelli V;Armocida C;Barbieri E;Cortesi L;Moscetti L;Piacentini F;Omarini C;Andreotti A;Gambini A;Battista R;Dominici M;Tazzioli G
本分析旨在评估在意大利北部一个受严重急性呼吸综合征相关冠状病毒-2 （SARS-CoV-2）病毒严重影响的地区，在诊断和前期治疗阶段中断乳腺癌（BC）阶段乳房x光检查2个月的后果。本回顾性单机构分析比较了2020年5月至2020年7月筛查中断2个月后诊断出的BC的临床病理特征，与2019年同期定期进行乳房x光检查时诊断出的BC。停止乳房x线摄影筛查2个月导致原位BC诊断率显著下降（- 10.4%），淋巴结阳性（+11.2%）和III期BC（+10.3%）增加。主要影响是在高增殖率的BC患者亚组。其中，淋巴结阳性BC增加18.5%，III期增加11.4%。在低增殖率患者亚组中，观察到III期肿瘤增加9.3%，尽管淋巴结阳性肿瘤保持稳定。尽管筛查中断，但随后立即开展了确定诊断和开始治疗的程序。我们的数据显示，停止BC筛查2个月后，淋巴结阳性和III期BC增加。这些发现支持了全速快速恢复BC筛查的建议，并制定了适当的优先策略，以减轻危害并满足感染预防要求。由于covid - 19大流行，一些乳房x光检查服务中断。停止BC筛查2个月导致原位BC减少，淋巴结阳性和III期BC诊断增加。主要影响是在高增殖率的BC患者亚组。尽管筛查中断，但随后立即进行了开始治疗的程序。建议在满足感染预防要求的情况下恢复BC筛查。
The present analysis aims to evaluate the consequences of a 2-month interruption of mammographic screening on breast cancer (BC) stage at diagnosis and upfront treatments in a region of Northern Italy highly affected by the severe acute respiratory syndrome-related coronavirus-2 (SARS-CoV-2) virus. This retrospective single-institution analysis compared the clinical pathological characteristics of BC diagnosed between May 2020 and July 2020, after a 2-month screening interruption, with BC diagnosed in the same trimester of 2019 when mammographic screening was regularly carried out. The 2-month stop in mammographic screening produced a significant decrease in in situ BC diagnosis (−10.4%) and an increase in node-positive (+11.2%) and stage III BC (+10.3%). A major impact was on the subgroup of patients with BC at high proliferation rates. Among these, the rate of node-positive BC increased by 18.5% and stage III by 11.4%. In the subgroup of patients with low proliferation rates, a 9.3% increase in stage III tumors was observed, although node-positive tumors remained stable. Despite screening interruption, procedures to establish a definitive diagnosis and treatment start were subsequently carried out without delay. Our data showed an increase in node-positive and stage III BC after a 2-month stop in BC screening. These findings support recommendations for a quick restoration of BC screening at full capacity, with adequate prioritization strategies to mitigate harm and meet infection prevention requirements. Due to the COVID19 pandemic, several mammographic screening services were disrupted. A 2-month stop in BC screening led to decreased in situ BC and increased node-positive and stage III BC diagnosis. A major impact was on the subgroup of patients with BC at high proliferation rates. Despite screening interruption, procedures to start treatments were subsequently carried out without delay. Restoration of BC screening at full capacity with infection prevention requirements is recommended.
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